Health plans currently spend valuable time and resources manually reviewing authorizations for patient services that could be automatically approved in seconds. Current prior authorization processes can take days to weeks for final determinations. As a result, providers and patients experience delays in care and the frustration of administrative roadblocks impeding care delivery.

Apixio® Apicare AuthAdvisor generates predictive decisions based on our industry-leading Apicare AI platform. By utilizing historical administrative data and decisions data, our solution can approve requests in seconds and route requests requiring more detailed clinical review to the appropriate reviewers.

Benefits:

• Drive cost-savings by reducing the volume of unnecessary reviews with automated decision requests based on our AI-trained model.

• Fine-tune thresholds with user-enabled controls on a procedure-by-procedure basis.

• Deliver immediate results by deploying in existing workflows through APIs.

• Enhance provider and member satisfaction with timely feedback from requests.

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